Organization
PRIME PEDIATRIC DENTAL GROUP PA
Active
Parent organization
PRIME PEDIATRIC DENTAL GROUP PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRIME PEDIATRIC DENTAL GROUP PA
Authorized official
DR. JOSE MELLADO DMD (PRESIDENT)
(305) 251-5390
Entity
Organization
Contact information
Practice address
2950 SW 8TH ST, MIAMI, FL 33135-2827
(305) 251-5390
Mailing address
2950 SW 8TH ST, MIAMI, FL 33135-2827
(305) 251-5390
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
09/25/2024
Last updated
09/30/2024
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